Percutaneous device closure of atrial septal defect (ASD) is an alternative treatment to surgery. The main advantages of the percutaneous approach include avoidance of surgery, short procedure time and hospital length, in addition to comparable rates of complications. However, percutaneous device closure is associated with infrequent early and late complications including device embolization, air embolism, cardiac tamponade and thrombotic complications. We report a rare complication of silent and late device embolization of the ASD occluder device into the right pulmonary artery, three months after implantation.

Cardiovascular risk factors are important causes of morbidity and mortality in postmenopausal women. The aim of this cross-sectional study was to evaluate the cardiovascular risk factors in 207 postmenopausal Turkish women over 45 years old in a rural district of West Anatolia, Manisa Muradiye district. A questionnaire on socioeconomic and sociodemographic characteristics was conducted in the women followed by the measurement of blood pressure, fasting blood glucose, cholesterol levels, and waist-hip ratio along with an electrocardiogram (ECG). The European Cardiology Society risk index was used for cardiovascular risk evaluation. The results showed that 86% percent of the women will be carrying more than a 5% probability of developing a cardiovascular risk in the next 10 years. Moreover, the results proved 7% of the women are at high risk for a cardiovascular condition. Hypertension, hypercholesterolemia, and impaired glucose tolerance, were observed in 62%, 35.3%, and 13.5% of the women, respectively. Seven percent had smoked for at least six months. Fourteen cases had complained of exercise angina and pathologic ECG signs were diagnosed in one-third of these 14 cases. The waist-hip ratio measured 0.8 or more in 66.2% of the cases, with a range of 68-147 cm (mean; 95.6 +/- 11.55). The results indicate that the risk of a cardiovascular condition developing is extremely high in postmenopausal West Anatolian women and increases with age. Morever, the prevalance of hypertension increased with age and was very closely related with low socioeconomic levels. These hazardous cardiovascular disease risk factors should be considered as high priority health problems in rural and low socioeconomic areas of developing communities. Intervention to modify the cardiovascular risk factors should be included in routine primary health care programs.

Atrial fibrillation (AF) is a cardiac dysrhythmia commonly seen in clinical practice especially after cardiac surgery. It is associated with increased morbidity and mortality for the patients. The pathogenesis of AF is not exactly understood yet, but there is growing data about the relationship between AF and inflammation. Cardiac surgery itself is a big source for inflammation. It causes major surgical trauma, ischemia/reperfusion injury, hypothermia, low arterial pressure, and the equipment of cardiopulmonary bypass makes a large foreign surface thus it activates inflammatory response. There is a large number of data about the treatment options of AF and there are also strategies, which are related to reduction of inflammatory activation during cardiopulmonary bypass. In order to review the relationship between cardiac surgery, inflammation, AF and treatment strategies in patients with AF, we conducted a search through Pubmed for articles in English using the keywords: "atrial fibrillation, cardiac surgery, inflammation, medical therapy, surgical therapy, ablation therapy" from January 2012 to present. We also searched separately for each alternative treatment modality on Pubmed. To identify further articles, we also looked into related citations in review articles and commentaries. We searched thoroughly the guidelines published by the European Society of Cardiology (2016), and the American Heart Association/ American College of Cardiology/ Heart Rhythm Surgery (2014). Many studies concluded that inflammation contributes in the occurrence of AF. Inflammatory markers, such as CRP, interleukins and complements have high sensitivity and specificity for prediction of AF whether the patient having cardiac surgery or not. Betablockers, diltiazem and amiodarone are the most commonly used drugs for rate control in AF following surgery. Although there are some new therapeutic approaches to reduce postoperative inflammatory activation, such as the use of vitamins, fatty acids, statins, or technical improvements to cardiopulmonary bypass unit like miniaturized bypass circuits, heparin coating of the circuits, leukocyte filters, or various surgical approaches like off-pump coronary bypass surgery, we still need more effective strategies to reduce both postoperative inflammation and postoperative AF risk after cardiac surgery. Today we use more advanced invasive and surgical treatment strategies for AF although we need far more advanced technics to reduce perioperative inflammatory activation, which actually causes AF.

BMP-4 and noggin levels were lower in the diabetic group. High BMP-4 levels were significantly associated with albuminuria. Further studies are warranted to determine the role of BMP-4 in the pathogenic processes underlying albuminuria and hyperglycemia in patients with type 2 diabetes.